Suturing device

ABSTRACT

A suturing device with built-in needle-transfer of a double-ended needle has a first jaw element with a first needle lock device for retaining and releasing a first end of the needle; a second jaw element with a second needle lock device, wherein the jaw elements are movable between an open and closed position; and a needle-transferring mechanism for alternately transferring the needle from one of the jaw elements to the other when the jaws are moved from the open to the closed position. The needle-transferring mechanism includes a first rotatable wheel connected to the first needle lock device, the first wheel having a first wheel inner portion rigidly connected to a first wheel outer portion and a second rotatable wheel connected to the second needle lock device, said second rotatable wheel comprising a second wheel inner portion rigidly connected to a second wheel outer portion.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is the U.S. national stage of PCT/EP2019/063309 filedMay 23, 2019, which claims priority of Sweden patent application1850630-3 filed May 25, 2018, both of which are hereby incorporated byreference in their entirety.

FIELD OF THE INVENTION

The present disclosure relates to an improved suturing device, inparticular to an automated or semi-automated disposable suturing device.Preferably, the device is a one-handed suturing device.

BACKGROUND OF INVENTION

Surgical procedures in the abdominal cavity requires access that can beachieved via open surgery or minimally invasive techniques. Opensurgical procedures are very common and about 2 million procedures areperformed annually in the US. Following the procedure the abdominal wallhas to be closed. Experimental and clinical data gives sound informationabout the surgical technique required to minimize abdominal wallcomplications after surgery. Wound infections and incisional hernias arereduced if a continuous suture technique is used and the thread is fourtimes the length of the incision. The stiches should be small and placedtightly. The suturing process is tedious and time-consuming anddifficult to achieve following long and strenuous surgical procedures.Operating room time is expensive and time savings can provide care formore patients. Furthermore, abdominal closure is the most common groundfor needle injuries during surgery.

The existing suturing instruments are associated with a number ofdisadvantages and inconveniences. They are typically difficult to use,do not guarantee the safety of the patient, lack precision and are oftenmechanically complex. It would therefore be desirable to provide aninstrument that would help the surgeon to adhere to the correct way ofclosing the abdomen and to reduce the time needed to perform thesuturing. Preferably, such an instrument should also reduce the risk forprick injuries, simplify suture placement and be mechanically simple androbust.

SUMMARY OF INVENTION

The present disclosure relates to an improved suturing device withbuilt-in needle-transfer of a double-ended needle. The suturing devicemay be a one-handed device, wherein the transfer of the needle betweenthe jaws preferably is automatic in the sense that the mechanism foropening/closing of the jaws also controls, or is mechanicallysynchronized with, the transfer of the needle, preferably without theneed of additional switches for controlling the transfer of the needle.

In a first embodiment the suturing device comprises:

-   -   a first jaw element comprising a first needle lock device for        retaining and releasing a first end of the double-ended needle;    -   a second jaw element comprising a second needle lock device for        retaining and releasing a second end of the double-ended needle,    -   wherein the first and second jaw elements are movable in        relation to each other between an open position and a closed        position;    -   a needle-transferring mechanism for alternately transferring the        double-ended needle from one of the jaw elements to the other        when the first and second jaws are moved from the open position        to the closed position, said needle-transferring mechanism        comprising:        -   a first rotatable wheel connected to the first needle lock            device, said first rotatable wheel comprising a first wheel            inner portion rigidly connected to a first wheel outer            portion; and        -   a second rotatable wheel connected to the second needle lock            device said second rotatable wheel comprising a second wheel            inner portion rigidly connected to a second wheel outer            portion,            wherein a first force is propagated from the first jaw            element to the second rotatable wheel and wherein a second            force is propagated from the second jaw element to the first            rotatable wheel when the first and second jaw elements are            moved in relation to each other from the open position to            the closed position, thereby causing the first and second            rotatable wheels to rotate, wherein the first and second            rotatable wheels are arranged such that a rotation of the            first and second rotatable wheels causes one of the needle            lock devices to lock the double-ended needle and the other            needle lock device to release the double-ended needle. The            needle-transferring mechanism may thereby be arranged such            that a difference in rotation and/or a difference in a            rotation cycle, for example a shift/offset, between the            first and second rotatable wheels provide the transfer            mechanism.

The presently disclosed suturing device with built-in needle-transferprovides an accurate and robust design of a suturing device forimproved, in particular faster and more precise, surgical suturing,wherein a user may push the jaws together repeatedly using one hand totransfer the doubled-ended needle back and forth between the jaws. Theprocess of releasing the needle from one jaw and locking the needle inthe other jaw when the jaws are closed may be effectuated by asequential mechanism inside the tool. In a first embodiment, two wheelsturn in opposite directions when the jaws are closed, which allowsopening and closing of needle retention elements alternately, such thatthe needle is passed back and forth between the first and second jawwhen the jaws are opened and closed repeatedly. In a second andalternative embodiment, the two wheels may instead be arranged to rotatein the same direction. However, if each wheel has an outer profile whichengages with the needle lock devices and controls the position of theneedle lock elements in the axial direction of the corresponding jaw, ashift in the outer profiles between the wheels may provide the mechanismfor alternately transferring the double-ended needle from one of the jawelements to the other when the first and second jaws are moved from theopen position to the closed position.

Preferably, the needle-transferring mechanism is arranged to operate ina coordinated sequence of steps triggered by the angle between the jaws,which changes during a closing process. Two wheel drive mechanisms, forexample in the form of drive shafts, may engage with both the jaws andthe wheels in such a way the wheels start turning when the angle betweenthe jaws are lower than a threshold angle during a closing process.Below this threshold, when the wheels start turning as the jaws arebeing closed, the outer profile of the wheels may define further steps,wherein each step may correspond to a configuration of the first andsecond needle lock devices. In one embodiment, each needle lock devicecomprises a wheel engagement element which moves backwards/forwards inthe axial direction of the jaws to retain/release the needle when thewheels rotate. This mechanism is further explained in examples in thedetailed description of the invention below.

The two wheels may be shaped such that the process is the same when theneedle is passed form the first jaw to the second jaw compared to whenthe needle is passed from the second jaw to the first jaw. This allowsthe user to operate the suturing device by pushing the two jawstogether, whereby the needle is transferred from a first jaw to a secondjaw, then relying on the force of a jaw opening spring to open the jaws,then pushing the jaws together again to transfer the needle from thesecond jaw to the first jaw, and so forth. The needle-transferringmechanism may thereby be automatic in the sense that there are noadditional switches for controlling the transfer of the needle.

DESCRIPTION OF DRAWINGS

FIG. 1 is a view of an embodiment of the presently disclosed suturingdevice with built-in needle-transfer of a double-ended needle, whereintwo rotatable wheels are arranged to rotate in opposite directions tocontrol the retention and release of two needle lock devices;

FIG. 2 is a perspective view of the suturing device of FIG. 1 ;

FIG. 3 is a detailed view showing an embodiment of the retention andrelease of one end of a needle;

FIG. 4 is a detailed view showing an embodiment of one of the rotatablewheels having an inner portion and an outer portion, wherein at leastthe inner portion has an outer profile having cam elements and engagingwith the needle lock device to control the position of the needle lockelements;

FIG. 5A-H are views showing an example of a sequence of steps of aclosing procedure of the jaws, wherein each step corresponds to an anglebetween the jaw elements, explaining the sequence of mechanism fortransferring the double-ended needle from one jaw to the other;

FIG. 6 is a detailed view showing an embodiment of the needle retentionelement with an opening for receiving and locking the needle and aneedle pusher element;

FIG. 7 is a perspective view of another embodiment of the presentlydisclosed suturing device with built-in needle-transfer of adouble-ended needle, wherein the two rotatable wheels are arranged torotate in the same direction and outer profiles of the wheels areshifted in relation to each other;

FIG. 8 is a detailed view an embodiment of two jaw elements with twowheel engagement elements; and

FIG. 9 is a detailed view showing two rotatable wheels arranged torotate in the same direction wherein the outer profiles are shifted inrelation to each other, and a common drive wheel connected to the tworotational wheel.

DETAILED DESCRIPTION OF THE INVENTION

The present disclosure relates to a suturing device with aneedle-transfer of a double-ended needle, the suturing devicecomprising: a first jaw element comprising a first needle lock devicefor retaining and releasing a first end of the double-ended needle; asecond jaw element comprising a second needle lock device for retainingand releasing a second end of the double-ended needle, wherein the firstand second jaw elements are movable in relation to each other between anopen position and a closed position; and a needle-transferring mechanismfor alternately transferring the double-ended needle from one of the jawelements to the other when the first and second jaws are moved from theopen position to the closed position. More precisely the double-ended isalternately transferred from one needle lock device to the other needlelock device. The suturing device may be a suturing device for closingthe abdomen. Typically, the jaw elements are pivotable in relation toeach other around a common pivot joint. Preferably, theneedle-transferring mechanism comprises: a first rotatable wheelconnected to the first needle lock device; and a second rotatable wheelconnected to the second needle lock device. The first and secondrotatable wheels may be arranged such that a rotation, such that adifference in rotation and/or a shift or offset, between the first andsecond rotatable wheels causes one of the needle lock devices to lockthe double-ended needle and the other needle lock device to release thedouble-ended needle when the first and second jaw elements are moved inrelation to each other from the open position to the closed position. Inone embodiment, the first and second rotatable wheels are arranged torotate simultaneously and/or synchronized, preferably with the samerotational speed in order to provide a synchronized and/or coordinatedrelease and retention of the two needle lock devices. The rotatablewheel based solution allows the user to transfer the needle form one jawto the other in one movement, for example by pushing the jaws togetherdirectly or by pushing two handles together, thereby pushing the jawstogether. If the user then releases the jaws or handles, a spring coil,or another solution providing the same functionality may force the jawsto return to an open position. This mechanism may be provided by meansof a jaw opening spring arranged between the first jaw element and thesecond jaw element. If the user then pushes the jaws together again, theneedle-transferring mechanism may cause the double-ended needle totransfer back from the second jaw to the first jaw. This means that theuser can repeatedly push the jaws together and then let the spring coilmove them back to the open position to perform a suturing process.

In particular this automatic or semi-automatic mechanism may allow forone-handed use. The device is robust, efficient and relatively simple inits construction. The mechanism is hence suitable for a disposablesuturing device.

A first embodiment of the presently disclosed suturing device comprisestwo rotatable wheels, wherein the first and second rotatable wheels arearranged to rotate in opposite directions when the first and second jawelements are moved in relation to each other from the open position tothe closed position, thereby causing one of the needle lock devices tolock the double-ended needle and the other needle lock device to releasethe double-ended needle. The rotation of two rotatable wheels may bedriven by shafts connected to the jaw elements. When the jaw elementsare closed towards each other, the shafts may push the wheels torotation. Outer profiles of the wheels may thereby cause the needle lockdevices to lock and release the double-ended needle alternately.

A second embodiment of the presently disclosed suturing device comprisestwo rotatable wheels, wherein the first and second rotatable wheels arearranged to rotate in the same direction, and wherein outer profiles ofthe wheels are shifted in relation to each other when the wheel rotates.In this embodiment the shifted profiles may be arranged such that theycontrol the needle lock devices to lock and release the double-endedneedle alternately.

Needle Lock Device Mechanisms

A first needle lock device is associated with the first jaw element anda second needle lock device is associated with the second jaw element. Aneedle lock device within the present disclosure may be referred to as acomplete mechanism for retaining and releasing one end of a double-endedneedle. The needle lock device may thereby comprise a number ofconnected or engaging elements. A needle lock device may be incorporatedinto a jaw element. A needle lock device may engage or connect to one ofthe rotatable wheels in one end, and extend via, preferably inside, thejaw element, whereas the other end may be able to retain and release oneend of the needle as explained in further detail below. Preferably, thefirst rotatable wheel engages with the first needle lock device and thesecond rotatable wheel engages with the second needle lock device. Thiscan be achieved by wheel engagement elements engaging with the first andsecond rotatable wheels, respectively. As the wheel rotate, the outerprofile of the wheels may move the wheel engagement elements backwardsand forwards in the axial direction of the corresponding jaw element inresponse to a rotation of the corresponding rotatable wheel. Forwardshas the meaning in the direction towards the free end of a jaw element.Consequently, backwards means the opposite direction, i.e. towards thewheels.

The wheel engagement elements may be engagement shafts. In order tomaintain contact between the wheel engagement elements and the varyingouter profiles of the rotatable wheels, each wheel engagement elementmay comprise a first spring coil configured to maintain a pressure fromthe wheel engagement element to the corresponding rotatable wheel.

As a person skilled in the art would understand, there are differentsolutions for controlling the retention and release of the double-endedneedle based on the movement of the wheel engagement elements back andforth in the axial direction of each jaw element. FIG. 1 shows oneembodiment in which each wheel engagement element is connected to aneedle retention element extending in the longitudinal direction of thecorresponding jaw element. Each needle retention element may comprise anopening, preferably adjacent to the freed ends of the jaw elements,where the suturing typically takes place, for receiving the double-endedneedle. The opening may have a shape capable of locking the double-endedneedle. One mechanical solution for locking the needle comprises anopening having a wide section and narrow section, for example asubstantially key hole shaped opening. The double-ended needle mayaccordingly have a portion which is narrower or thinner than the rest ofthe needle, which, when introduced into the narrow section, such as agrove or slot, of the opening of the retention element, prevents theneedle from movement in the longitudinal direction of the needle. Thedouble-ended needle may have such a groove or slot in both ends.

In order to prevent that the needle, when locked in the narrow sectionof the opening, moves to the wide section and falls off, each needlelock device may comprise a needle pusher element configured to push thedouble-ended needle against a body part as shown in FIG. 6 . The needlepusher element may be arranged to push the double-ended needle backwardstowards a body part of the corresponding jaw element. A needle pusherconnecting element may form part of the needle lock device and connectthe wheel engagement element and the needle retention element. There maybe a second spring configured to maintain a pressure on the needlepusher element towards the body part.

In addition to the built-in mechanism for retaining and releasing theneedle the presently disclosed suturing device may comprise a manualneedle release mechanism for manually releasing the needle from the jawif needed. Each jaw may have its own manual needle release element. Themanual needle release mechanism may be implemented as for example a pin,grip or button on the jaw, extending into the jaw and controlling forexample the needle lock device or an element of the needle lock device,such as the retention element or the wheel engagement element.

Arrangements of Rotatable Wheels

As stated above, the needle-transferring mechanism comprises: a firstrotatable wheel connected to the first needle lock device; and a secondrotatable wheel connected to the second needle lock device. The firstand second rotatable wheels may be arranged such that a difference inrotation between the first and second rotatable wheels causes one of theneedle lock devices to lock the double-ended needle and the other needlelock device to release the double-ended needle when the first and secondjaw elements are moved in relation to each other from the open positionto the closed position.

A first embodiment of the presently disclosed suturing device comprisestwo rotatable wheels, wherein the first and second rotatable wheels arearranged to rotate in opposite directions when the first and second jawelements are moved in relation to each other from the open position tothe closed position, thereby causing one of the needle lock devices tolock the double-ended needle and the other needle lock device to releasethe double-ended needle. A second embodiment of the presently disclosedsuturing device comprises two rotatable wheels, wherein the first andsecond rotatable wheels are arranged to rotate in the same direction,and wherein outer profiles of the wheels are shifted in relation to eachother when the wheel rotates.

The rotatable wheels may comprise a number of cam element distributedalong an outer profile or contour of the each wheel. The distance fromthe center of the wheel to the outer periphery of the wheel can be saidto determine the position of the corresponding wheel engagement element.Hence, when a wheel rotates the wheel engagement element moves back andforth in an axial direction of the jaw element.

This movement can be used in a mechanism to retain and release thedouble-ended needle. The cam elements may therefore be shaped such thatwhen the rotation wheels rotate, the shape of the cam elements controlthe movement backwards and forwards of the wheel engagement elements toretain and release the corresponding end of the double-ended needle.

Each cam element may have a front ridge and a back ridge. The back ridgemay be steeper than the front ridge. The rotational direction of thewheels are defined in relation to the shape of the wheel and exemplifiedin FIG. 4 . In the configuration of the figure, the second rotationwheel will rotate clockwise, such that the second wheel engagementelement will be in contact and first move along the longer front ridge(30) of the cam element and then fall into over the back ridge (31). Thelatter may correspond to a locking mechanism. In one embodiment, aborder section (32) between the front ridge and the back ridge, whichmay also be seen as a groove or recess, is configured to hold the wheelengagement element of one of the needle lock devices in a retractedposition causing the needle lock device to be in a locked configuration.An elevated section of each rotation wheel may be configured to hold thewheel engagement element of one of the needle lock devices in anextended position causing the needle lock device to be in a releaseconfiguration. FIG. 4 shows the second rotation wheel. The firstrotation wheel may be mirrored in relation to the second rotation wheel.Hence, from an opposite perspective, i.e. viewing the suturing deviceform the opposite, the first rotation wheel may have the same shape asthe second rotation wheel and may rotate clockwise from thatperspective. Thus, the first and second rotation wheels may rotate inopposite directions.

The rotatable wheels may have separate portions for being driven torotate and for controlling the needle lock devices. This may beimplemented in the form of an inner portion and an outer portion,wherein the inner and outer portions are rigidly connected. The innerportion of the first rotatable wheel may be referred to as the firstwheel inner portion. The inner portion of the second rotatable wheel maybe referred to as the second wheel inner portion. The outer portion ofthe first rotatable wheel may be referred to as the first wheel outerportion. The outer portion of the second rotatable wheel may be referredto as the second wheel outer portion. The inner portion and the outerportion may have separate cam elements. An example of such anarrangement is shown in FIG. 4 . The outer portion of each rotationwheel may engage with the wheel drive mechanisms of one of the jawelements. The shape of the outer portion may therefore be adapted forthis purpose, as can be seen in the example of FIG. 4 . The innerportion of the rotation wheel may engage with the wheel engagementelement of the same jaw element. The inner and outer portions do notnecessarily have these configurations in the sense that the innerportion may, alternatively, be driven to rotate the wheel and the outerportion for controlling the needle lock devices.

The suturing device may further comprise reverse lock mechanisms toprevent the wheels from rotation backwards when the jaw elements aremoved from a closed to an open position. A first reverse lock mechanismmay be arranged to prevent the first rotatable wheel to rotate backwardswhen the first and second jaw elements are moved from the closedposition to the open position. A second reverse lock mechanism may bearranged to prevent the second rotatable wheel to rotate backwards whenthe first and second jaw elements are moved from the closed position tothe open position. The reverse lock mechanism may be implemented in theform of hook elements (23), as shown in FIG. 4 , which can be hookedaround an edge or ridge of the rotation wheels, such as hooked around anedge of the outer portion of the wheel, as shown in the example.

Wheel Driving Arrangements

Several embodiments for driving the rotation of the rotation wheels arepossible.

In one embodiment, such as a one-handed embodiment, the user may holdthe jaw elements in one hand and push the jaw elements together. In suchan embodiment the jaw elements may comprise elements which engage withthe rotation wheel and transfer a force to the wheels when the suturingdevice is being closed such that the wheels rotate. The suturing devicemay comprise a first wheel drive mechanism for rotation of the secondrotation wheel and a second wheel drive mechanism for rotation of thefirst rotation wheel. The first wheel drive mechanism may be a firstwheel drive shaft and the second wheel drive mechanism may be a secondwheel drive shaft. The first wheel drive mechanism may be configured topropagate a force from the first jaw element to the second rotationwheel such that the second rotation wheel rotates in a first direction(forward) when the first and second jaws are moved from the openposition to the closed position. The second wheel drive mechanism mayoperate in the same way. In one embodiment the presently disclosedsuturing device comprises a jaw opening control element, which allowsthe user the manually control the rotatable wheels. There may also betwo jaw opening control elements, one for each rotatable wheel, in orderto be able to control the wheels individually. The jaw opening controlelement may be implemented, for example, as an extension of therotatable wheels. The rotatable wheels may thereby have a firstmechanical portion that is typically not directly exposed to the user.This portion may comprise the inner and outer portions of the rotatablewheel. This mechanical parts are typically placed behind a casing of thesuturing device. The jaw opening control element may be an exposed partof the rotatable wheel, preferably comprising a grip or handle. The usercan then control the locking and releasing of the needle manually byapplying a force to the jaw opening control element.

In a second embodiment the wheels may be driven by a multidrive element(35), for example a handle, as shown in the example of FIG. 7 . Thehandle may drive both the rotation wheels and the opening/closing of thejaw elements. As long as these two mechanisms are synchronized such thatthe closing of the jaw elements correspond to a sequence of mechanismfor retaining and releasing the double-ended needle, several embodimentsare possible. In the example of FIG. 7 , there are three controlelements extending along the device, as also shown in FIG. 8 . A jawopening control element (27) in the form of a shaft (27) controls theopening and closing of the jaw elements (3, 4), preferably assisted by aspring. The needle retention elements (12) are controlled by two wheelengagement elements (9, 10) in the form of two further shafts (9, 10).The mechanisms are preferably synchronized in the sense that the handlecontrols them.

DETAILED DESCRIPTION OF DRAWINGS

The invention will in the following be described in greater detail withreference to the accompanying drawings. The drawings are exemplary andare intended to illustrate some of the features of the presentlydisclosed suturing device, and are not to be construed as limiting tothe presently disclosed invention.

FIG. 1 shows one embodiment of the presently disclosed suturing device(1) with built-in needle-transfer of a double-ended needle (2), whereintwo rotatable wheels (7, 8) are arranged to rotate in oppositedirections to control the retention and release of two needle lockdevices (5,6). Two jaw elements (3, 4) are pivotable in relation to eachother around a common pivot joint (24). A jaw opening spring (25) movesthe jaws back to an open position after a user has pushed the jawelements (3, 4) together to transfer the double-ended needle (2). Thefirst jaw element (3) has a first needle lock device (5). The second jawelement (4) has a second needle lock device (6). A first rotatable wheel(7) has a first wheel inner portion (19) and a first wheel outer portion(not visible). A second rotatable wheel (8) has a second wheel innerportion (19′) and a second wheel outer portion (20′). A first wheelengagement element (9), which is part of the first needle lock device(5), engages with an outer contour of the inner portion (19) of thefirst rotatable wheel (7). A second wheel engagement element (10), whichis part of the second needle lock device (6), engages with an outercontour of the inner portion (19′) of the second rotatable wheel (8).First springs (11) maintain a pressure from the wheel engagementelements (9, 10) to the corresponding rotatable wheel (7, 8). The needlelock devices (5, 6) each comprise a needle retention element (12) and aneedle pusher element (13) configured to push the double-ended needle(2) backwards (i.e. towards the wheels). Each needle lock device (5, 6)comprises a needle pusher connecting element (15) and a second spring(14) for maintaining a pressure on the needle pusher element (13). Eachneedle lock device (5,6) comprises a needle pusher grip element (26) forlimiting the axial movement between the needle pusher connecting element(15) and corresponding wheel engagement element (9, 10). A force from afirst wheel drive mechanism (16) from the first jaw element (3) makesthe second rotatable wheel (8) rotate. A force from a second wheel drivemechanism (17) from the second jaw element (4) makes the first rotatablewheel (7) rotate. Each rotatable wheel (7, 8) has a number of camelements (18) distributed over the circumference. The suturing device(1) of the example comprises first and second reverse lock mechanisms(21, 22), each having a hook (23). A jaw opening control element (27) isrigidly connected to the one of the rotatable wheels. The jaw openingcontrol element is arranged for manually controlling one of the firstand second rotatable wheels to open the jaws (3, 4). A further jawopening control element may be connected to the other of the rotatablewheels.

FIG. 2 shows a perspective view of the suturing device (1) of FIG. 1 .From the perspective view it can be seen that the second rotatable wheel(8) has an inner portion (19′) and an outer portion (20′). The innerportion (19′) has a cam profile which can be used to move the wheelengagement element (10) of the second jaw element (4) backwards andforwards in the axial direction of the jaw element. The first wheeldrive mechanism (16) is arranged to push the outer and smaller portion(20′) to make the wheel rotate. The perspective also needle pusher gripelement (26) in the form of a screw (26) arranged in a hole slightlywider than the screw (26). A jaw opening control element (27) is rigidlyconnected to the one of the rotatable wheels and arranged for manuallycontrolling the second rotatable wheel (8) to control the jaws and/orthe locking and releasing of the needle. A further jaw opening controlelement may be connected to the other of the rotatable wheels.

FIG. 3 shows an embodiment of the retention and release of one end of adouble-ended needle (2). A needle retention element (12) has a widerpart (28) and a narrower part (29). If a narrower part of the needle (2)or a groove in the needle (2) is arranged in the narrow part (29), theneedle (2) is in a locked position. The figure also discloses a needlepusher element (13) pushing the needle (2) backwards.

FIG. 4 shows an embodiment of one of the rotatable wheels having aninner portion (19) and an outer portion (20), wherein at least the innerportion (19) has an outer profile having a number of cam elements (18)and engaging with the needle lock device to control the position of theneedle lock elements. Each cam element (18) of the inner portion (19)comprises a steep back ridge (31) and a curved front ridge (30). Theborder section (32) between the front ridge (30) and back ridge (31)corresponds to the second wheel engagement element (10) being in itsleftmost position in the figure, corresponding to the needle lock device(6) being in a retention position. On the front ridge (30), which is thelonger curved surface between two back ridges (31), there is an elevatedsection (33). When the second wheel engagement element (10) is placed onthe elevated section (33), the needle lock device (6) is in a releaseconfiguration. A jaw opening control element (27) is rigidly connectedto the outer portion (20) of the rotatable wheel. A further jaw openingcontrol element may be connected to the other of the rotatable wheels.

FIG. 5A-H show an example of sequence of steps of a closing procedure ofthe jaws, wherein each step corresponds to an angle between the jawelements, explaining the sequence of mechanism for transferring thedouble-ended needle from one jaw to the other. FIG. 5A: At 2.3° betweenthe jaw elements, second wheel drive mechanism (17) starts engaging withthe outer portion (20). The same occurs at the first rotatable wheel.FIG. 5B, 1.53°: wheel drive mechanisms (16, 17) now drive the rotatablewheels in opposite directions. The first wheel engagement element (9)starts moving towards the double-ended needle (2), thereby starting theopening process of the first needle lock device (5). FIG. 5C, 1.1°: Thedouble-ended needle (2) enters the needle retention element of thesecond jaw element. FIG. 5D, 1.0°, shows the first needle retentionelement (12) which is about to lose its grip of the double-ended needle(2). FIG. 5E, at 0.7°, shows the first wheel engagement element (9) andthe inner portion (19) of the first rotatable wheel (7). The first wheelengagement element (9) is about to enter a curved section of the camelement. In this position the needle is loose from the needle retentionelement (12) of the first needle lock device (5). FIG. 5F: at 0.2° thesecond wheel engagement element (10) is about to go down the back ridge(31) of a cam element (18) of the second rotatable wheel (8). FIG. 5G,0.12°: the second wheel engagement element (10) is passing the backridge (31) and thereby locks the double-ended needle (2) in theretention element (12) of the second needle lock device (6). FIG. 5H,0°: In this position the double-ended needle (2) is locked in theretention element (12) of the second needle lock device (6).

FIG. 6 shows an embodiment of the needle retention element (12) with anopening for receiving and locking the needle (2), the opening having awide section (28) and a narrow section (29). The needle retentionelement (12) is configured in locked position. A needle pusher element(13) is arranged to push the needle (2) backwards against a body part(36) of the jaw element.

FIG. 7 shows another embodiment of the presently disclosed suturingdevice (6) with built-in needle-transfer of a double-ended needle (2),wherein the two rotatable wheels (7, 8) are arranged to rotate in thesame direction and outer profiles of the wheels are shifted in relationto each other. This embodiment comprises a multidrive element (35) fordriving both the opening/closing of the jaw elements (3, 4) and the tworotatable wheels (7, 8). This mechanism is further described in FIGS.7-8 .

FIG. 8 shows an embodiment of two jaw elements (3, 4) with two wheelengagement elements (9, 10). A jaw opening control element (27) in theform of a shaft (27) controls the opening and closing of the jawelements (3, 4), preferably assisted by a spring. The needle retentionelements (12) are controlled by two wheel engagement elements (9, 10) inthe form of two further shafts (9, 10). The first engagement element (9)controls the retention and release of the first jaw element (3). Thesecond engagement element (10) controls the retention and release of thesecond jaw element (4). If the outer profiles of the wheels are shiftedin relation to each other when the wheel rotates, the shafts movebackward and forwards in the axial direction of the device to controlthe retention and release of the double-ended needle.

FIG. 9 shows two rotatable wheels (7, 8) arranged to rotate in the samedirection wherein the outer profiles are shifted in relation to eachother, and a common drive wheel (34) connected to the two rotationalwheels (7, 8).

LIST OF ELEMENTS IN FIGURES

-   -   1—suturing device    -   2—double-ended needle    -   3—first jaw element    -   4—second jaw element    -   5—first needle lock device    -   6—second needle lock device    -   7—first rotatable wheel    -   8—second rotatable wheel    -   9—first wheel engagement element    -   10—second wheel engagement element    -   11—first spring    -   12—needle retention element    -   13—needle pusher element    -   14—second spring    -   15—needle pusher connecting element    -   16—first wheel drive mechanism    -   17—second wheel drive mechanism    -   18—cam element    -   19—inner portion    -   20—outer portion    -   21—first reverse lock mechanism    -   22—second reverse lock mechanism    -   23—hook    -   24—pivot joint    -   25—jaw opening spring    -   26—needle pusher grip element    -   27—jaw opening control element    -   28—wide section (of needle retention element)    -   29—narrow section (of needle retention element)    -   30—front ridge (of cam element)    -   31—back ridge (of cam element)    -   32—border section between the front ridge and the back ridge    -   33—elevated section (of cam element)    -   34—common drive wheel    -   35—multidrive element    -   36—body part (of the jaw element)        Further Details of the Invention    -   1. A suturing device with a needle-transfer of a double-ended        needle, the suturing device comprising:        -   a first jaw element comprising a first needle lock device            for retaining and releasing a first end of the double-ended            needle;        -   a second jaw element comprising a second needle lock device            for retaining and releasing a second end of the double-ended            needle,        -   wherein the first and second jaw elements are movable in            relation to each other between an open position and a closed            position;        -   a needle-transferring mechanism for alternately transferring            the double-ended needle from one of the jaw elements to the            other when the first and second jaws are moved from the open            position to the closed position, said needle-transferring            mechanism comprising:            -   a first rotatable wheel connected to the first needle                lock device; and            -   a second rotatable wheel connected to the second needle                lock device, wherein the first and second rotatable                wheels are arranged such that a rotation of the first                and second rotatable wheels causes one of the needle                lock devices to lock the double-ended needle and the                other needle lock device to release the double-ended                needle when the first and second jaw elements are moved                in relation to each other from the open position to the                closed position.    -   2. The suturing device according to item 1, wherein the first        rotatable wheel comprises a first wheel inner portion rigidly        connected to a first wheel outer portion, and wherein the second        rotatable wheel comprises an second wheel inner portion rigidly        connected to a second wheel outer portion.    -   3. The suturing device according to item 2, wherein a first        force is propagated from the first jaw element to the second        rotatable wheel and wherein a second force is propagated from        the second jaw element to the first rotatable wheel when the        first and second jaw elements are moved in relation to each        other from the open position to the closed position, thereby        causing the first and second rotatable wheels to rotate    -   4. The suturing device according to any of the preceding items,        wherein the first and second rotatable wheels are arranged to        rotate in opposite directions when the first and second jaw        elements are moved in relation to each other from the open        position to the closed position, thereby causing one of the        needle lock devices to lock the double-ended needle and the        other needle lock device to release the double-ended needle.    -   5. The suturing device according to item 1, wherein the first        and second rotatable wheels are arranged to rotate in the same        direction, wherein outer profiles of the wheels are shifted in        relation to each other when the wheel rotates.    -   6. The suturing device according to any of the preceding items,        wherein the first and second rotatable wheels are arranged to        rotate simultaneously and/or synchronized, preferably with the        same rotational speed.    -   7. The suturing device according to any of the preceding items,        wherein each needle lock device comprises a wheel engagement        element engaging with the first and second rotatable wheels,        respectively.    -   8. The suturing device according to item 7, wherein each wheel        engagement element is configured to move backwards and forwards        in the axial direction of the corresponding jaw element in        response to a rotation of the corresponding rotatable wheel.    -   9. The suturing device according to item 8, wherein a movement        backwards and forwards of each wheel engagement element causes        the corresponding needle lock device to retain and release the        corresponding end of the double-ended needle, respectively.    -   10. The suturing device according to item 9, wherein each wheel        engagement element is an engagement shaft.    -   11. The suturing device according to any of items 2-10, wherein        each wheel engagement element comprises a first spring        configured to maintain a pressure from the wheel engagement        element to the corresponding rotatable wheel.    -   12. The suturing device according to any of items 2-11, wherein        each wheel engagement element is connected to a needle retention        element, the needle retention element extending in the        longitudinal direction of the corresponding jaw element.    -   13. The suturing device according to item 12, wherein each        needle retention element comprises an opening for receiving the        double-ended needle, wherein the opening has a shape capable of        locking the double-ended needle.    -   14. The suturing device according to item 13, wherein the        opening has a wide section and narrow section, wherein a narrow        portion of the double-ended needle can be locked in the narrow        section.    -   15. The suturing device according to any of the preceding items,        wherein each needle lock device comprises a needle pusher        element configured to push the double-ended needle backwards        towards a body part of the corresponding jaw element.    -   16. The suturing device according to item 15, wherein each        needle lock device further comprises a needle pusher connecting        element and a second spring configured to maintain a pressure on        the needle pusher element towards the body part.    -   17. The suturing device according to any of the preceding items,        further comprising a first wheel drive mechanism for rotation of        the first rotation wheel and a second wheel drive mechanism for        rotation of the second rotation wheel.    -   18. The suturing device according to item 17, wherein first        wheel drive mechanism is a first wheel drive shaft and the        second wheel drive mechanism is a second wheel drive shaft.    -   19. The suturing device according to any of items 17-18, wherein        the first wheel drive mechanism is configured to propagate a        force from the first jaw element to the second rotation wheel        such that the second rotation wheel rotates in a first direction        when the first and second jaws are moved from the open position        to the closed position.    -   20. The suturing device according to item 19, wherein the second        wheel drive mechanism is configured to propagate a force from        the second jaw element to the first rotation wheel such that the        first rotation wheel rotates in a second direction opposite to        the first direction when the first and second jaws are moved        from the open position to the closed position.    -   21. The suturing device according to any of the preceding items,        wherein each of the rotation wheels have cam elements.    -   22. The suturing device according to item 21, wherein the cam        elements are shaped such that when the rotation wheels rotate,        the shape of the cam elements control the movement backwards and        forwards of the wheel engagement elements to retain and release        the corresponding end of the double-ended needle.    -   23. The suturing device according to any of items 21-22, wherein        each cam element has a front ridge and a back ridge, wherein the        back ridge is steeper than the front ridge.    -   24. The suturing device according to item 23, wherein a border        section between the front ridge and the back ridge is configured        to hold the wheel engagement element of one of the needle lock        devices in a retracted position causing the needle lock device        to be in a locked configuration.    -   25. The suturing device according to any of items 23-24, wherein        an elevated section of each rotation wheel is configured to hold        the wheel engagement element of one of the needle lock devices        in an extended position causing the needle lock device to be in        a release configuration.    -   26. The suturing device according to any of the preceding items,        wherein each of the rotatable wheels comprises in inner portion        and an outer portion, wherein the inner and outer portions are        rigidly connected.    -   27. The suturing device according to item 26, wherein the inner        portion and the outer portion have separate cam elements.    -   28. The suturing device according to any of items 26-27, wherein        the outer portion of each rotation wheel engages with the wheel        drive mechanisms of one of the jaw elements and the inner        portion of each rotation wheel engages with the wheel engagement        element of the same jaw element.    -   29. The suturing device according to any of the preceding items,        further comprising a first reverse lock mechanism configured to        prevent the first rotatable wheel to rotate backwards when the        first and second jaw elements are moved from the closed position        to the open position, and a second reverse lock mechanism        configured to prevent the second rotatable wheel to rotate        backwards when the first and second jaw elements are moved from        the closed position to the open position.    -   30. The suturing device according to any of the preceding items,        further comprising a jaw opening control element for manually        controlling the first and/or second rotatable wheels to open the        jaws.    -   31. The suturing device according to any of the preceding items,        wherein the needle-transferring mechanism is automatic.    -   32. The suturing device according to any of the preceding items,        wherein the jaw elements are pivotable in relation to each other        around a common pivot joint.    -   33. The suturing device according to any of the preceding items,        further comprising a jaw opening spring arranged between the        first jaw element and the second jaw element.    -   34. The suturing device according to any of the preceding items,        wherein the suturing device is disposable.

The invention claimed is:
 1. A suturing device with a needle-transfer ofa double-ended needle, the suturing device comprising: a first jawelement comprising a first needle lock device for retaining andreleasing a first end of the double-ended needle; a second jaw elementcomprising a second needle lock device for retaining and releasing asecond end of the double-ended needle, wherein the first and second jawelements are movable in relation to each other between an open positionand a closed position; a needle-transferring mechanism for alternatelytransferring the double-ended needle from one of the first and secondjaw elements to the other when the first and second jaw elements aremoved from the open position to the closed position, saidneedle-transferring mechanism comprising: a first rotatable wheelconnected to the first needle lock device, said first rotatable wheelcomprising a first wheel inner portion rigidly connected to a firstwheel outer portion, wherein the first wheel inner portion and the firstwheel outer portion have separate cam element profiles; and a secondrotatable wheel connected to the second needle lock device, said secondrotatable wheel comprising a second wheel inner portion rigidlyconnected to a second wheel outer portion, wherein the second wheelinner portion and the second wheel outer portion have separate camelement profiles, wherein a first force is propagated from the first jawelement to the second rotatable wheel and wherein a second force ispropagated from the second jaw element to the first rotatable wheel whenthe first and second jaw elements are moved in relation to each otherfrom the open position to the closed position, thereby causing the firstand second rotatable wheels to rotate, wherein the first and secondrotatable wheels are arranged such that a rotation of the first andsecond rotatable wheels causes one of the first and second needle lockdevices to lock the double-ended needle and the other of the first andsecond needle lock devices to release the double-ended needle.
 2. Thesuturing device according to claim 1, wherein the first and secondrotatable wheels are arranged to rotate in opposite directions when thefirst and second jaw elements are moved in relation to each other fromthe open position to the closed position, thereby causing one of thefirst and second needle lock devices to lock the double-ended needle andthe other of the first and second needle lock devices to release thedouble-ended needle.
 3. The suturing device according to claim 1,wherein the first and second rotatable wheels are arranged to rotate inthe same direction, wherein outer profiles of the first and secondrotatable wheels are shifted in relation to each other when the firstand second rotatable wheels rotate.
 4. The suturing device according toclaim 1, further comprising a first wheel drive mechanism engaging withthe second wheel outer portion.
 5. The suturing device according toclaim 1, further comprising a second wheel drive mechanism engaging withthe first wheel outer portion.
 6. The suturing device according to claim1, wherein the first and second rotatable wheels are arranged to rotatesimultaneously and/or synchronized, preferably with the same rotationalspeed.
 7. The suturing device according to claim 1, wherein the firstneedle lock device comprises a first wheel engagement element engagingwith the first rotatable wheel, and wherein the second needle lockdevice comprises a second wheel engagement element engaging with thesecond rotatable wheel.
 8. The suturing device according to claim 7,wherein the first wheel engagement element engages with the first wheelinner portion.
 9. The suturing device according to claim 7, wherein thesecond wheel engagement element engages with the second wheel innerportion.
 10. The suturing device according to claim 7, wherein: thefirst wheel engagement element is configured to move backwards andforwards in an axial direction of the first jaw element in response tothe rotation of the first rotatable wheel and wherein a movementbackwards and forwards of the first wheel engagement element causes thefirst needle lock device to retain and release the first end of thedouble-ended needle, respectively; and the second wheel engagementelement is configured to move backwards and forwards in an axialdirection of the second jaw element in response to the rotation of thesecond rotatable wheel and wherein a movement backwards and forwards ofthe second wheel engagement element causes the second needle lock deviceto retain and release the second end of the double-ended needle,respectively.
 11. The suturing device according to claim 7, wherein eachof the first rotatable wheel and the second rotatable wheel have camelements shaped such that when rotated, the shape of the cam elementscontrols the movement backwards and forwards of the first and secondwheel engagement elements to retain and release corresponding respectiveends of the double-ended needle.
 12. The suturing device according toclaim 11, wherein each cam element has a front ridge and a back ridge,wherein the back ridge is steeper than the front ridge.
 13. The suturingdevice according to claim 12, wherein a border section between the frontridge and the back ridge is configured to hold the wheel engagementelement of one of the first and second needle lock devices in aretracted position causing the one of the first and second needle lockdevices to be in a locked configuration.
 14. The suturing deviceaccording to claim 12, wherein: an elevated section of the firstrotatable wheel is configured to hold the first wheel engagement elementof the first needle lock device in an extended position causing thefirst needle lock device to be in a release configuration; and anelevated section of the second rotatable wheel is configured to hold thesecond wheel engagement element of the second needle lock device in anextended position causing the second needle lock device to be in arelease configuration.
 15. The suturing device according to claim 1,further comprising a jaw opening control element for manuallycontrolling the first and/or second rotatable wheels to open the firstand second jaw elements.
 16. The suturing device according to claim 15,wherein the jaw opening control element is rigidly connected to one ofthe first rotatable wheel or the second rotatable wheel.
 17. Thesuturing device according to claim 15, comprising a further jaw openingcontrol element, wherein the jaw opening control element and further jawopening control element are arranged to control the first and secondrotatable wheels individually.
 18. A suturing device with aneedle-transfer of a double-ended needle, the suturing devicecomprising: a first jaw element comprising a first needle lock devicefor retaining and releasing a first end of the double-ended needle; asecond jaw element comprising a second needle lock device for retainingand releasing a second end of the double-ended needle, wherein the firstand second jaw elements are movable in relation to each other between anopen position and a closed position; a needle-transferring mechanism foralternately transferring the double-ended needle from one of the firstand second jaw elements to the other when the first and second jawelements are moved from the open position to the closed position, saidneedle-transferring mechanism comprising: a first rotatable wheelconnected to the first needle lock device, said first rotatable wheelcomprising a first rotation axis and a first wheel inner portion rigidlyconnected to a first wheel outer portion; and a second rotatable wheelconnected to the second needle lock device, said second rotatable wheelcomprising a second rotation axis coaxially aligned with the firstrotation axis and a second wheel inner portion rigidly connected to asecond wheel outer portion, wherein a first force is propagated from thefirst jaw element to the second rotatable wheel and wherein a secondforce is propagated from the second jaw element to the first rotatablewheel when the first and second jaw elements are moved in relation toeach other from the open position to the closed position, therebycausing the first and second rotatable wheels to rotate, wherein thefirst and second rotatable wheels are arranged such that a rotation ofthe first and second rotatable wheels causes one of the first and secondneedle lock devices to lock the double-ended needle and the other of thefirst and second needle lock devices to release the double-ended needle.19. The suturing device according to claim 18, wherein the first needlelock device comprises a first wheel engagement element engaging with thefirst rotatable wheel, and wherein the second needle lock devicecomprises a second wheel engagement element engaging with the secondrotatable wheel.
 20. The suturing device according to claim 19, whereineach of the first rotatable wheel and the second rotatable wheel havecam elements shaped such that when rotated, the shape of the camelements controls the movement backwards and forwards of the first andsecond wheel engagement elements to retain and release correspondingrespective ends of the double-ended needle.